Ascaris Lumbricoide en vía biliar

Abstract

This work describes a 59 – years – old male patient with specific symptoms of biliary pathology of obstructive origin. I shows up with a 48 – hours evolution, accompanied by nausea an vomiting for repeated occasions. Symptoms do not get mild. On the contrary, it has been increasing so that the patient goes to the emergency service of the IESS Latacunga General Hospital where the physical examination shows signs of mild dehydration. There is abdominal pain on the right hypochondrium to the superficial and deep palpation that spreads to the iliac fossa on the same side. Hospitalization, is decided, where abdominal ultrasound is performed and it reports dilation of the bile duct although it is not possible to identify the obstruction cause. Therefore, it is decided to perform a magnetic cholangioresonance in which the diagnosis of bile duct obstruction is confirmed; apparently it is cholelithiasis. Since the gallstones are small, the patient is told about the possibility of performing retrograde endoscopic cholangiopancreatography. Because it is less invasive, surgical intervention is avoided, once the endoscopic examination was performed, an endoscopic sphincteretomy was perfomed in which the gallstone was removed, and as a fortuitous finding a lumbricoid ascari which was stuck in the bile duct. The ascaris lumbricoide parasite in the longest human intestinal nematode. It is about 53 cm long and 0.5 cm thick. It is usually foud in the jejunum small intestine, but it can migrate to the biliary tract, causing biliary colic, obstructive symptoms, jaundice end cholelithiasis. This was noted in our patient who debuted with an obstructive symptom.